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In approximately 10% of adolescents with severe dysmenorrheic symptoms, pelvic abnormalities such as endometriosis or uterine anomalies may be found. Potent prostaglandins and leukotrienes play an important role in generating the symptoms of dysmenorrhea. Nonsteroidal anti\u2010inflammatory drugs (NSAIDs) are the most common pharmacologic treatment for dysmenorrhea. A loading dose of NSAIDs (typically twice the regular dose) should be used as initial treatment for dysmenorrhea in adolescents, followed by a regular dose until symptoms abate. Adolescents with symptoms that do not respond to treatment with NSAIDs for three menstrual periods should be offered hormonal treatment such as combined estrogen\/progestin oral contraceptive pills for three menstrual cycles. Adolescents with dysmenorrhea who do not respond to this treatment should be evaluated for secondary causes of dysmenorrhea. The adolescent care provider's role is to explain the pathophysiology of dysmenorrhea to every adolescent female, address any concern that the patient has about her menstrual period, and review effective treatment options for dysmenorrhea with the patient.<\/jats:p>","DOI":"10.1196\/annals.1429.007","type":"journal-article","created":{"date-parts":[[2008,6,23]],"date-time":"2008-06-23T18:08:18Z","timestamp":1214244498000},"page":"185-195","source":"Crossref","is-referenced-by-count":81,"title":["<i>Dysmenorrhea in Adolescents<\/i>"],"prefix":"10.1111","volume":"1135","author":[{"given":"Zeev","family":"Harel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,7,25]]},"reference":[{"key":"e_1_2_13_2_2","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1542\/peds.99.4.505","article-title":"Secondary sexual characteristics and menses in young girls seen in office practice: a study from the Pediatric Research in Office Settings","volume":"99","author":"Herman\u2010Giddens M.E.","year":"1997","journal-title":"Pediatrics"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2005.07.016"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-57-1-82"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.68.5.661"},{"key":"e_1_2_13_6_2","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/0002-9378(82)90433-1","article-title":"An epidemiologic study of young women with dysmenorrhea","volume":"144","author":"Anderesch B.","year":"1982","journal-title":"Am. 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